Acting Up as Consultant Policy

Trainees who are within one year of their anticipated completion of training date are eligible to ‘Act Up’ as consultants, for a fixed-term period of a maximum of three months (pro rata for less than full time trainees).

“Acting up” provides trainees with the experience of navigating the transition from junior doctor to consultant, whilst maintaining the supervision associated with being a trainee.

Reference is made to acting up within ‘A Reference Guide to Postgraduate Specialty Training’, which states:

Trainees may be able to take time out of programme to act up as a consultant and may be able to credit this time towards a CCT or CESR(CP) if there is specific provision for this in their specialty curriculum. This would normally be undertaken in the final year of training.

Trainees acting up as consultants will need to have appropriate supervision in place. If the experience afforded by this post is in a location already approved for training in the relevant specialty by the GMC, additional prospective approval for OOPT is not required from the GMC.

If acting up as a consultant is undertaken in another location, prospective approval will only be necessary if the acting up placement is relevant to gaining the competences, knowledge, skills and behaviours required by the curriculum. In these circumstances, OOPT will normally be for a period of three months or pro rata for LTFT trainees. However, length of periods approved for acting up as a consultant may be specified in the relevant curricula and where referenced in a curriculum specific provisions around acting up roles need to be adhered to.

Eligibility

Opportunities to act up are not available to all trainees and are only possible if the opportunity arises and an employing or host local education provider/Trust extends an invitation.

Trainees wishing to act up should normally be within one year of their anticipated completion of training.

Trainees acting up as consultants will need to have appropriate named supervision arrangements in place at all times including on call work, and approval will only be considered if the acting up placement is relevant to gaining competences, knowledge, skills and behaviours required by the curriculum. Trainees with unmet objectives, unsatisfactory ARCP outcomes or outstanding competences are not normally eligible to apply to act up. Trainees will maintain their National Training Number throughout the acting up opportunity.

The General Medical Council (GMC) and some Colleges/Faculties have guidance and/or additional requirements when applying for Acting Up to Consultant posts. It is the responsibility of the individual trainee to check their respective curriculum, Royal College/Faculty and GMC guidance and fully comply with any requirements.

Post Certificate of Completion of Training (CCT) / Locum Arrangements

Trainees who are post CCT are not normally eligible to act up but will be expected to take up the post as Locum Consultant. Although acting up often fulfils a genuine service need, it is not the same as being a Locum Consultant. Upon taking up a Locum Consultant post trainees will be required to resign their National Training Number.

When in an ‘acting up’ position, the term ‘acting up’ and not ‘locum’ must be applied.

Approval Process

Before commencing an acting up position, trainees must formally apply and request approval using the application form. Trainees are responsible for arranging for the completion of Sections A, B, C and D, and for sending the completed form, along with evidence of support for the arrangement from the relevant local education provider(s) (including the funding element) to HEE.

Recognition of the period of acting up is subject to conditions set by the Colleges/Faculties and the competences contained within their curricula. These conditions vary between colleges. It is therefore important that the trainee is aware of their own college guidance on acting up prior to submitting an application.

Applications should normally reach the HEE local office a minimum of six weeks prior to the proposed start date of the ‘Acting Up’ arrangement. Trainees and Trusts are encouraged to have discussions as early as possible to facilitate the approval process, upon identification of acting up opportunities.

A trainee can only act up into a post within the UK and which relates to their specialty Certificate of Completion of Training (CCT).

Recognition of acting up when stated in the specialty curriculum

If the specialty curriculum specifically references a period of acting up as a consultant, then no further College/Faculty or GMC approval will be required unless stated otherwise within the curriculum.In these situations, the period of acting up will automatically count towards training and will be undertaken in GMC approved training sites. The Training Programme Director must ensure that the post meets the requirements of the trainee’s developmental plan and that appropriate supervision is provided.

Recognition of acting up when not stated in the specialty curriculum

If the specialty curriculum does not make reference to a period of acting up as a consultant, then the subsequent acting up period will not be recognised as training by the relevant College/Faculty and GMC and therefore cannot be counted towards training time. In these situations, the trainee will need to consult the out of programme policy and submit an application for out of programme experience (OOPE). In these circumstances the subsequent OOPE application should be clearly marked as acting up.

A trainee normally acts up within the same HEE local office area. In exceptional circumstances, a trainee may wish to act up in another region. Where the acting up post is in the same training programme that the trainee is enrolled onto, additional prospective approval is not required from the General Medical Council. If the acting up post is in a different training programme, the usual out of programme approval process must be followed. GMC approval is not required in instances where trainees are acting up in approved training locations.

Acting Up and Period of Grace

To retain access to the Period of Grace, a trainee must complete their period of ‘Acting Up’ before their CCT date. There is not normally access to acting up once the CCT date is reached.